gms | German Medical Science

Objectives/Interrogation: To evaluate the effectiveness and acceptability of the use of adrenaline as a mean to achieve hemostasis in open release of median nerve compared to the use of tourniquet in the arm.

Methods: Prospective, experimental, controlled, randomized study was made up of 50 participants; divided into two groups of 25 each. Group 1 operated with application of local anesthesia under transverse carpal ligament and with tourniquet (WT) and 25 with WALANT technique. In the WT, 2% lidocaine 10ml was injected, and in the WALANT 2% lidocaine plus epinephrine was injected at a concentration of 1: 200,000 in total of 10ml, below the dermis. Pain was measured at the time of anesthesia with the analogous visual scale, surgical time, amount of bleeding, heart rate, blood pressure and pulse oximetry, pre, trans and postoperative.

Results: The analysis of association by groups between the 2 kind of treatments showed significant differences in the heart rate (HR) pre, trans and postsurgical (p: 0.045, 0.001, 0.001, respectively), the other variables studied did not show significant p values, when associating the quantity of bleeding with the used methods, patients with WALANT obtained significantly higher values with respect to WT, when performing the correlation analysis in groups the relationship of bleeding with WALANT was lost, while patients wearing a tourniquet maintained a P < 0.05, showing a relative benefit.

Conclusion: WALANT is a good alternative of anesthetic technique for the release of the median nerve, since it presents fewer complications, absence of pain by the tourniquet, without the need of an operating room for the procedure, support from a single assistant, short hospital stays, the patient stays awake during the surgery without pain, as well as, decrease in costs and increase in the benefits for the patient and the surgeon, being a simple, safe and effective anesthetic technique to achieve haemostasis in the surgical site.